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tv   Book TV  CSPAN  February 15, 2015 5:00am-6:31am EST

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agent. i thought was cool to have an agent. at the end of my residency i said look why don't we just take my pieces and staple them together and call it a book? we pitched that idea which didn't go over very well. the editor, of my publisher said we don't really like your idea but we have an idea. why don't you write about your residency, a memoir of development, novel of education? that is what i ended up doing and got turned into my first book which is called in turn. end there are a lot of pieces i
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published as the president but a lot of stuff i didn't publish. one thing corry told me was the diary and write down the stuff that is interesting to you. so i did and i thought it was so important. when young doctors and aspiring writers asked me how do you get started? i say you have to record your reflections. ..
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i had been in school for 19 years. 19 years after graduating from high school. i had that quantum dot detour. so i was just ready to be done, and reap some rewards for all that all those sleepless nights and what i found was that doctors were very unhappy, and when you're in training, the focus is on the physiology and learning about the heart. it's not really about the culture of practice. so i was largely blinded to that. and then i took on my first role and i'm talking to doctors and i find they're very unhappy
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with medical practice today. and it wasn't just about the stresses we all know. it upabout the paperwork and the malpractice fears and so on. it was a deeper problem. there was a -- what i started to think of as an existential crisis. it was more that doctors felt they weren't being able to practice medicine the way they were trained to practice the way they aspired to practice and that cass deeply troubling to them. and so i sort of watched this and learned a little bit. i was fairly happy. i was an academic practice. and working with trainees and i specifically chose an academic practice because i wanted to teach -- i wanted to be around
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young people and -- rather than -- and people who had that naivete that i had, that i wanted to hold on to, and -- but shortly after i started in my practice i found myself with a significant amount of debt and feeling i had to moonlight so make ends meet. started a new family. and most folks will be surprise it that a lot of academic physician does that. they moonlight on the side. one reason we choose academia is we want to be around academics we want to be around young physicians, we want to teach, but the salary structure is very different, and in then medicine today you're rewarded for doing as much as possible. the fee for service model, do more more, more. and one of the reasons why i
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chose academic met sin, diwant to be in that position where i had to do more and more and more. but then i found i had to start moonlighting and i found a practice in queens, with a cardiology friend of my brother, who offered me this gig going -- doing stress tests and supervising stress tests on the weekends. and this is where i really learned about how medicine is practiced in some parts of this country. now, most doctors are good. but there's no question that there is a subset in my profession that has taken advantage of the fee for service system and it's not -- you can call it whatever you want. some doctors will get upset by
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the implication there's fraud going on. let's not call it fraud. let's say the system creates moral hazards that encourages doctors to respond to financial incentives and this is happening, okay? when i was a resident when i learned about health care economics there was an example of an orthopedic group that under the fee for service system was doing 200 to 300 total hip replacements for a year. when they went to a bundled model, that number dropped from 200 to 300 -- i don't remember the exact number -- to one. one total hip replacement. you can't tell me doctors don't respond to financial instance senttives. we do. doctors are just us a human as anyone. and so i'm working in this
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practice and it was a mill. there were literally this line of unsuspecting patients getting ready to have stress tests, many of which were honestly unnecessary. and the more i worked there the dirtier i felt. i felt really dirty that i had to do this. but i felt like i had no options at that point with the financial situation i was in, and so that precipitated a real crisis in me. it was a -- maybe it was a mid-life crisis. i don't know. but it took a toll on me, took a toll on my relationship with my
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family and the book is about what i call the mid-life crisis of american met din, and also about my own personal crisis, and how i worked my way out of it. and eventually i did. but -- i was able to re-ininvestigate rate my personal relationships and i'm in a much better place today than i was about six seven years ago. howhowever, american medicine is still in a crisis. what are re going to do about american medicine? there's no simple solution unfortunately. i think that the fee for service system does create a lot of problems that eventually, i believe, will need to be addressed and the system will
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need to be supplanted by something else. i don't know exactly what that system will look like. but it's going to happen. it's happening. anytime you have a huge system that is responsible for one out of every six dollars we spend, and it's so dysfunctional then it's going to get to a tipping point, and i believe it's at that point because you can't have a system that is so gargantuan that affects all of our lives and have no one be happy with it. i mean doctors are unhappy but most importantly, patients are unhappy. you ask any patient. patients are mart. they know when they're getting the short shrift. they know when they're doctor isn't listening to them. they often times suspect they're being asked to undergo
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unnecessary tests. they know what's going on. they know they can't find a primary care physician today, or if they do they have to wait three months to get an appointment in some parts of the country. so there's a lot of dysfunctionallity in the system. it will change. now, for doctors i think that we have to reclaim what is important to us. the system is in a state where insurance companies, the government, are in many ways telling us how to practice and a lot of doctors feel almost like pawns in this system, and when i graduated from medical school the graduation speaker had some wise words.
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he said know what is important to you. the ideals you hold near and dear and stick to them. so i think those words apply just as much to me now as a mid-life practitioner, as they did when i was an intern. we have to identify what is important, and for me, in the end, it's about the human interactions and if you talk to doctors who are unhappy, even the unhappiest doctors will say the best part of their jobs is enter acting with people, talking to people. and that is something that no entity can take away. so, for me, it's always about the human moments and what i like to call the gentle surprises. i want to give you one story
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about the gentle surprises of medicine. i remember when i was a third year resident. i was -- i went to the emergency room in the south bronx, and i had a two-week stint there, and late one night i was asked to drain the fluid out of the belly of a woman with alcoholic cirrhosis. her belly was full of fluid, and it's a very brute force procedure. you put a needle in, hook it up to a tour, put the tube in a bucket and drain the fluid. so i went ins' and introduced myself and said, i'm here to drain the fluid out of your belly. and she said okay, sure, go ahead. and she still had alcohol on her breath. so, i said, okay. i cleaned up her belly with iodine soap and i put in the
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catheter the needle to the catheter, and put the tube into a bucket, and i started filling the bucket and i said, look, if you move and this comes out i'm not putting it back in. and she says oh, okay sure. so i'm just there watching the fluid drain and a nurse comes in and says doctor you just got paged. she was carrying my beeper. i said, oh, okay. well, can you keep an eye on her while i go out and answer my page. she said sure. and i remind my patient, you move and the catheter comes out i'm not going to put it back in because i have another ten patients to see. she said okay. so i go out and answer my pain. three minutes later i walk back into the room and the catheter is out the buckets are all upturned and there's like fluid all over the floor.
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and i was like oh my gosh. so i look at her accusingly and i said, i thought i told you not to move. and she said doctor i didn't. a man came in here and had a seizure on the buckets. i was like, oh, god. and then the nurse walks in and i said i thought i told you to keep an eye on her. and she said i did. but then man walked in here and had a grand mal seizure on the bucket. this is what doctors experience. and these are special moments. no insurance company can take that away from you. okay. we doctors have to become more
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conscious about what kind of physician we want to be. and i write in the book about sort of three professional archetypes. knights, naves, and pawns. and in my parents' era and my grandfather's era, doctors were knights. they were admired like no other professional group. right up there with astronauts. and for good reason. american medicine improved patients' longevity from 65, right before world war ii to 71, less than a generation later. improvement of six or seven years of life and that was because of polio vaccinations and antibiotics and coronary bypass surgery and pacemakers.
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doctors really delivered. they were knights. and then doctors went through a phase where they became thought of as naves, and the whole culture shifted. when doctors were knights, that was the era of "general hospital." early on when doctors -- when dr. kildare, and then during this navish period, it was the era of m.a.s.h. and hawkeye but hawkeye was a great doctor but he was flawed. and there was "e.r." that painted doctors as human, as flawed. so i talk about knights, naves, and pawns and the reality is that doctors are all three. we all have a touch of these
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three professional archetypes in us and we have to try to bring out the best, okay? and we have to do it in a culture that doesn't really understand what we're going through. and i'll tell you one last story and then i'll take questions. so when i was a resident, we used to round in the intensive care unit. so there was a -- one night when i had been on call, and i -- the following morning we were rounding on our patients, and anyone has been in expensive care unit knows the horrible tragedies that happen in icus and our intensive care unit was no different.
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there's a guy who had been misdiagnosed with a slip eddies can and had actually severed his spinal cord and was now completely paralyzed and there were patients who had multiple my loma on ventilators and it was a horrible unit, and so our teamed stayed up all night and we were rounding with an attending neighborhood abe sanders, and he was a great attending. he was a jocular fellow, and so we were going through and we found ourselves in a room of a patient who was on a ventilator, and we were presenting the case and sanders sort of like looked off, looking through the window and any of you who have been at new york hospital know that
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there's a greenburg pavilion built over the fdr drives and looks out on to the east river. so sanders said, come over here. look out the window. and it was brilliantly sunny day, and there were boats on the river, and we looked down there and there was a boat and there were a few people on the boat, and they looked like they were having a great time. sipping bloody marys and they all looked beautiful, you know, and we were like sweaty and disgusting and had been on call all night and there was a fellow on board who was looking up at the hospital and he was -- turned out he was looking right at the window that we happened to be standing at. and sanders said, see that guy down there? and i looked at him and he was about sanders' age but is fit, tan, and he was with all these
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beautiful people and he was looking up and he said that guy down there, do you know know what he is thinking? we all looked and oh, are we going through this? we just want to get out of the hospital. you know what he is thinking? i looked down and none of us ventured a guess. and sanders says, that guy is thinking, i should have been a doctor. [laughter] >> and this is what we struggle with as physicians. people still view our profession in simple terms but today, i have a more nuanced view of medicine, and doctors are not perfect, and our profession isn't perfect but i do feel that doctors still want to be
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knights, and i think that there's a lot that we have to go through in the next ten 15, 20 years; we need to figure out a way to reclaim our professionalism, we need to figure out how we want to practice. we need to improve access to medical care. we need to control costs otherwise we're going to bankrupt our economy. so there's a lot that we have to do but american medicine is technologically the best in the world, and i fervently hope that we'll find some solutions to the mess we're in so that medicine can really reclaim its american medicine can reclaim its place as unquestionably the best in the world. so, i will end there and take some questions.
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but thank you so much for coming. [applause] >> i'm writing about my mother's end of life issues. this is where i find -- [inaudible] -- my mother has alzheimer's it was clear in her chart and every time we went to the hospital with her, the doctors talked to her and asked her questions she can't speak and this goes on and on and on, and you tell a doctors over and over again, she has no capacity to answer your questions. we're her advocates.
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but this is gone on and on. with physicians. they don't pay attention. she is obviously gone. and yet they continue to ask her, how do you feel? what do you want? and extremely frustrating. when i finally found a doctor who would listen to me and said no more hospitals, no more interventions, hospice, cocktail palliative care, i literally wept. i couldn't believe he was listening to me. >> that's profound. i think unfortunately your experience is not unique. end of life care is probably the single weakest link in the american medical system and you're absolutely right. unfortunately, your intuition is probably correct the doctors didn't listen to you, and i see
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this every day. that we go into a patient's room and say, do you want this, this or this? and we present the information in ways they don't understand, sometimes they can't process it because they're sick, and they're anxious, and we do it all in the name of patient autonomy. right? the patient made this decision. we're giving the patient the decision. but patients don't always want the decision. they want to be guided. in many, many cases. and i remember one case -- i'll tell you briefly of a gentleman who came to the hospital and had apparently told all the doctors who were taking care of him that he never wanted to be intubated, and so he was in a situation where he was bleeding into his lungs, and i get a phone call
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saying that we did all -- question put in the stint and he is bleeding into his lungses and doesn't want to be intubated. and he is a young guy. and the choice was just let him drown, bleeding into his lungs, let him die, or do something about it. and i have witnessed so much of what you described of doctors sort of quickly presenting options, probably i've done it myself and then not really thinking about whether the patients understood the options. so, in this particular case, i knew that the interns and residents hadn't done a good job explaining to this fellow -- they probably asked him, if you were -- would you ever want to be on a breathing machine? and he probably said, no i don't want to -- but he didn't know exactly what he was signing
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up for. so they were going to actually let him die. ' and i said, i'm sure you didn't have the kind of conversation you needed to have with this fellow. i'm going to put the breathing tube in. so we put the breathing tube in, and even though he had written in the chart do not rhesus rhesus---h -- resuscitate, and we had a tough course and we eventually got the tube out, and i went off service. i came back on service, and i went to his room, and i said i was the doctor who decided to put in the breathing tube, and i know it was written in the chart you didn't want it but you would have died if you didn't get it. and he said, i've been through a lot. but thank you. and so we have to improve the communication because we can't just throw it all on the patient without guiding them. so, thank you for your comment. >> i'd like to say
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congratulations for making your life an adventure, rather than a goal-oriented, allowing things to bring you greater -- the research and the opportunities you have taken advantage of. i applaud you for that. >> thank you. >> number two the question is, what kind of oppositions or hurtles have you had to -- hurdles have you had to overcome or deal with in doing your research writing your books? i'm sure that everybody isn't patting you on the back. >> no. >> i'm curious. >> i've been pleasantly surprised that a lot of physicians have supported me in my writing. especially my colleagues. because doctors and patients aren't stupid. they see the system the way it is. they know there's a lot of stuff going on. some of it moral hazard nefarious, whatever you whatnot
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to call it. it's funny that there was a group of doctors, i would say that is shocked. maybe they're shocked i wrote about it or shocked this stuff is really going on. i'm not sure. and they've been fairly negative and vocal in their opposition to the book and then there's this group of doctors many of whom come up to me in the hospital and say doctor i heard you wrote this book and it was in "new york times" best seller. and you write about -- [inaudible] -- everyone knows this is going on. and so it's been a mixed response but i've been pleasantly surprised that a lot of people have been supportive.
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thank you. >> after seeing your wonderful review of -- i'd like to hear more -- particular live you being a cardiologist and physicist, how you feel technology will change the interaction between patient and the physician. >> i think it's already changed interaction. how many of you go in and good-do see you doctor and he or she doesn't look up from the computer screen. and this happens every day. with electronic medical records. and i think the technology may help us work our way out of that mess with better voice recognition software so that -- he writes about that, where we'll have software that will transcribe exactly what the doctors and patients are saying that you can edit later, but topol writes about virtual visits and telemedicine.
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i don't know how it's all going to pan out. i'm not sure if the quality will be there. the diagnosis at a distance. i personally feel that i need to see the patient listen to the patient, before i can make a good treatment plan, because every doctor has been through this. you read up on the patient you're going to go see, and they have a million issues, problems you read on the paper and then you walk in and they're reading "the new york times," and then you think that really totally changes how you see them. so i think that the direct face-to-face interaction is critical and not to mention that a machine is never going to be able to confer a healing touch. there's something about just touching your patient that is beneficial. so i think technology will play a role in changing and hopefully improving alaska
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certification but it's never going to replace a doctor. or nurse. >> i would like to ask -- you talked about what your fellow physicians think about your writing, but i thought you were brutally hospital about your mother, about your father about your father-in-law, and even about your wife. so what did they have to say? >> well, my wife is also a physician, and she has been on the journey with me, and she knows the crisis i went through. so i think she knows what is in the book. and she has read excerpts of it. i think she sort of has adopted a policy of benign neglect, like she doesn't want to read everything because she knows it all already.
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my brother, he is pretty hearty fellow thick skin, tough skin. he said, you do whatever you want and -- but overall my family has been very supportive, i think, and especially sonya who lets me do these things in and sort of keeps everything going and is a fantastic physician in her own right. so i've been lucky. but it's always that dubious spot when you're writing a memoir and writing about your life because on one hand when your life is into intertwined with other people's lives your story is partly their story so how do you disentangle the two. you can't. so i sort of -- when i was going through what was a tough crisis
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for me, i sort of adopted the policy of, i'm just going to write what i think, and so be it. and fortunately my family was supportive. >> you say that the system has to change to reduce the cost of health care. and you said you didn't know exactly how. i'm sure you have had some thoughts. i've been involved since 1960 and in 1970 we said it was out of control. and so it's still out of control. one time we thought maybe corporations having to pay the bill would be the catalyst. but obviously corporations just moved overseas and now they've stopped paying for health care. what's the catalyst that will cheat a change? >> when you talked early 1970s, that was in the nixon era, and nixon to his credit, saw the problem and actually
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instituted price controls on a number of industries, including health care, and then lifted them on a number of industries but kept them on health care. and then he was a republican. so price controls for a republican, you know he knew that the system was careening out of control. i think the percentage of gdp of health care in that era was something like nine percent, and today it's closer to 18-19%. so it's a huge problem. i think the fee for service system had to be supplanted by -- replaced by something else and i don't know how many of you read steven brills' knew new book. i think that he identifies the kaiser model as being the way out of the mess, where physicians and healthcare systems issue their own
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insurance product. they collect the premiums and they have the natural innocenttive to limit costs. of course you have to put in various protections into place so they don't unnecessarily limit spending, but i think the kaiser model is a very reasonable one. i grew up in southern california, in the '70s and '80s and we went to kaiser and we got perfectly good health care. some people advocate a single payer system. i don't see that happening in this country. what works in -- abroad doesn't -- won't work in the united states. i don't think. i remember one of my professors, who is teaching healthcare economics, was talking about the national health service in england and then someone asked him, why don't we just do that here. he is like, america is too different. in england they live in a rainy
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climate, they drink warm beer, they learn to tougher it out at a young age. that's not going to work in the united states. and he's probably right. so we have to tweak the system we have. if wore going build the system from scratch, i think the single payer system is the best system. >> enjoyed your books and i think your second book is a wonderful book because it describes the realities of the practice of medicine today. i think a lot of people don't understand the reality of practice of medicine today. i'm also a physician and i can relate to your book, particularly because i also met my wife as an intern at the new york hospital. she is here. the question i have is not a medical question. it's more of a literary question. how does a writer doctor find an agent and deal with an agent which is something you don't learn in medical school. >> i was fortunate because i was writing for "the new york times"
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so the agent actually found me and reached out to me. but let's talk afterwards. are you a writer? [inaudible] >> well, find me afterwards and we'll talk about it. thank you again. [applause] >> thank you so much. please join me in thanking dr. jauhar again. if you want to get your book signed, please allow him to get to the author's signing tent. we hope to see you back here at 2:50 for karen an about. -- abbott. [inaudible conversations]
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[inaudible conversations] you've been watching dr. sandeep jauhar. our live coverage continues in 20 minutes. karen abbott is next. she has written about women spies during the civil war. live coverage from the savannah book festival begins again shortly. [inaudible conversations]
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>> here's a look at some books being published this week. "new york times" reporter traces the origins of the board game monopoly. in the age of acquiescence criticizing the politics of fear. assistant professor for environmental studies at new york university proposes the public shaming of corporate and government leaders can be used as a form of nonviolent protest. and to explain the world, nobel prize winning physicist gives an analysis of modern science and travel writer talks about miss time living in rural chinese farming community. look for these titles in book stores this coming week and watch for the authors on booktv.org. >> this past thursday
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february 12th, david carr, media columnist for the "new york times," passed away at the age of 58. mr. carr appeared on booktv in 2008 to talk about his memoir posterior the night of the gun." >> i would have liked as a person to go back and find out that i was actually just a jolly kid from the suburbs who had a few problems. that's not what i found. in the course of the interviews i found out that i put a lot of people at risk around me and even when i did recover, it was owing to and in response both primarily for the love and attention that other people hold me -- a whole tribe of people came and were lifting and pulling on me, so my little heroic narrative didn't really fit with what i had learned. part of what got me started on the book was my daughters were
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going to college and tuition tends to focus the mind, tends to beckon the muse, and at the same time they were writing their essays for college and their essays about our life growing up together what it was like to have been born two and a half months premature to drug-addicted parents and then have your dad raise you mostly by himself, was fundamentally different than my own and i thought, after i read their essays, i wonder what other people would say and in my day job i work at the "new york times" and i've never really met a story that didn't get better when you applied the leverage of reporting to it. and so i said go back and interview a bunch of different people. it's all on a web site i made. you can check out the interviews i did. what i found was very different
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from what i remembered, and i realize that over time actually the truth -- i think you'll find this true in your own life -- between people. it's not -- if you think of the stories your family tells to explain itself to each other, how many of those stories are exactly precisely true? it's a way of creating narrative, of understanding our past and coming up with the version of ourselves in the future not all of these stories are bad. there's a point in the book where i assumed once i sobered up i was the presumptive custodial parent of my twins. so i went and saw a family law attorney who made it happen and i said, i was pretty much like baby jesus when you saw me. i was sober and the mother was
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not, and it was an open and shut case. she is a nice minnesota lady her name is barbara. you can see her on the videotape trying to figure out how to say what she is about to say to me. which is, you were really huge. you didn't smell very good. you dressed like a homeless person. and we wondered about the ethics of placing children in your hands, whether you fully understood the implications of that. and i'm going so not baby jesus. so says more like unholy mess actually. and the think about that is if i had known how i scanned at the time and how unfit i was to be a parent of these little baby girl i would have found that paralyzing. so this lie or fable i told myself allowed me to hang in
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long enough to kind of get -- to learn to be these guys' parent. so some of these stories we tell ourselves end up helping us on our way. [inaudible conversations] [inaudible conversations] >> more of booktv's live coverage of the savannah book festival shortly. [inaudible conversations]
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>> a look now at the current best selling nonfiction books according to "the new york times." topping the list a look at end of life care in "being mortal." norm former mike huckabee's take on culture. next in killing patton bill recounting the life of general george patton. then the investigation of a racially charged murder in, ghetto side. deep down dark comes in tenth place. the account of the 33 chilean miners trapped underground. and up next, steven brill's analysis of the healthcare system, followed by george w. bush's profile of his father
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george h.w. bush in 41. "the new york times" nonfiction best seller's his continues with the account of the life as a guantanamo bay detainee in guantanamo diary. and in i am malala nobel peace prize recipient recounts growing up in taliban controlled northern pakistan. and wrapping up the list a history of the underground railroad in, gateway to freedom. that's a look at the list of nonfiction best sellers according to "the new york times." >> reuters legal cooperate was an author. her book "breaking in the rise of sonia sotomayor." what did we learn about sonia sotomayor. >> we learned what she has been doing while she has been on the court for the last five years. this book is a political history that tells you how she got on the supreme court, and then what
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her life has been like since. it picks up where her memoir left off. you learn in the opening chapter how she persuaded her fellow justices to salsa with her. then you also learn how she has been effective behind the scenes on the law, and times when she hasn't been so effective. >> you haveless written a biography of antonin scalia. how are they different? how are they the same? >> well, there are a lot to the same in some ways. both new yorkers, one frommance one from the bronx. both very distinctive personalities, both checking up the court. she has been there since 2009. i would neverunder estimate what she is about to do -- never underestimate what she is about to do. she is a very good agent for himself, not unlike he was for himself, and they both understand the importance of being visible. look our visible justice scalia
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has been with his own book and look how visible she has been already. >> if you put on your legal correspondent hat for just a second where it's national press club night here at -- author night at the national press club. you just happened to be standing next to ted olson, the former solicitor general, when he gets before the court, what's the reaction of the justices to him and how does he play to them? >> that's a great question. something i've studied for a long time. i've been covering the court at least as long as ted olson has been around. they know him personally. they know him from way back when. he was in the reagan administration just the way chief justice john roberts was in the reagan administration. he social iowaed with antonin schoola. he actually spends new year's eve with justice right baiter ginsburg, justice scalia and elana kagan.
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they know him and will often refer to him by the first name. so the pay attention when he speaks like they pay attention to the regulars up there, and he has certainly -- let's see. he's been on 60 something arguments before the justices. he has some different quirks of which watches he wears what he argues, howl he does it. it's fascinating to watch him and watch hough the justices respond -- watch how the justices respond. they responsibility especially to many of the former solicitors general, just like seth waxman who was the solicitor general for bill clinton, and ted olson was she solicitor general for george w. bush. >> does he play to the justices? >> well, they all know to argue to justice kennedy. he is awesome in the swing vote position. or they know which justice might be the swing vote in their particular case. whether it's on something like same-sex marriage, that he is doing now or if it's on a pension case. these lawyers know who they need
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to convince. >> how o. -- you talk about this in "breaking in" how often can the justices have personal relationships with the lawyers that argue in front of them? >> they're all appointed for life but a the all had history before they came on the court. they were either in an administration with some of the justices, some of the lawyers themselves 0 maybe they once worked for them. elena kagan was the boss to several of the men and women who argue before the court now when she herself was solicitor general. there are plenty of professional and personal interactions. >> what's your next book? >> i don't know but it's so much fun. do you have an idea? this is more of a political history than a biography. and i'm kind of running out of the ones with really great personal stories. so, i've got to think long and hard. the other reason you have to think long and hard is you spend so much time doing it, pulls you
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away from your family and day job so you want to choose wisely. >> "breaking in" the name of the book the rice of sonia sotomayor, and the poll sicks of justice. -- politics of justice. [inaudible conversations] >> now live from savannah, author karen abbott her book, "liar, temptress soldier, spy." the story of four women who served undercover in the civil war. you're watching booktv on c-span2. [inaudible conversations]
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>> good afternoon, ladies and gentlemen. i'd like to wish you a happy valentine's day if you have forgotten. my name is chris aiken and i'm delighted to welcome you to the eighth null savannah book festival and to thank the presenting sponsors, georgia power and bob and jean fair cloth. we're blessed again to host celebrated authors of trinity unite methodist church beautiful venue made possible by the generosity of jim and ann his by. the international paper foundation, the savannah morning news and the savannah magazine and we would also like to thank c-span for coming to the festival and filming live here today in honor of valentine's day we'd also like to spread some love to all of our sponsors, our members, and individual donors who make saturdays free festival possible. if you would like to lend your support to the festival we
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welcome your donations and have provided yellow bucks for books buckets at the doors as you exit. before we get started i just like to remind you about a couple of things. please take this moment to turn off your cell phone. we also ask that there's no flash photography and most important thing today, especially as this hall is filled for the question and answer portion we ask that you line up down the center aisle. but also if you cannot get down, we don't expect you to leap from the balcony, i'd like to be sure you come forward if you have any questions up there just to lean -- stand up and speak as clearly as you can so the tv can catch your question. if you're planning to attend the closing address with ann and cliff rice tomorrow the correct time for the presentation is 3:00 p.m., and immediately following the presentation karen abbott will be signing festival purchased books. and before we welcome miss abbott let's thank roy and mage
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richard who sponsored her appearance here today. [applause] >> i also, before i really talk about karen, i would like to say that i am very honored to be speaking about her today because it just so happens my book club -- it was her book we read for the month of january. and so i am very honored and blessed to be with her and i am also from philadelphia. i have to put that in. my book club is here, i think. i think i see some of them in the audience. they can raise their hand. >> what book did you like? >> i wish. u.s.a. today has called karen an bolt the pioneer of sizzle history. for good reason. her first two books, "sin and the second city" and" american roads" embraced topics as the early club. the most famous brothel in american history, and famed strip tease artist gypsy rose lee. her latest book, "liar,
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temptress, soldier spy." tells the story of a socialite, a farm girl and abolitionist and a widow who became spies during the civil war. the women in the sub title including bell body who work for the confederacy and elizabeth and emma who were union operatives inch keeping with her other books the tale is extensively researched and clearly written. she is feature ever corrector to smithsonian magazine's history blog and -- a native of philadelphia she now lives in new york city with her husband and two african gray aparts, poe and dexter. please welcome karen abbott. [applause] >> thank you first for that
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lovely introduction. thanks for the savannah book festival for bringing me her and thank you for coming out here today. i'm very excited to be back in savannah, one of my favorite southern towns. in fact some of the most interesting anecdotes and quote is came across during my research for the book were about savannah women. for example in december of 1864, when union general william tecumseh sherman captured savannah one local woman proclaimed, i wish a thousand pins were stuck in his bed and he was strapped down on them. another woman and her friends were forced to host a group of occupying union soldiers in their homes, and speaking for that group wound woman quipped can just the meteor thought of being among the damn yankees are enough to make all prematurely old. of course there was another craftier side for these women.
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when they used their southern charges to bewitch the occupying soldiers and they called it, quote, buttering those yankees to serve our own ends. so i'll talk how i got into this book. i am from philadelphia. i was born and raised in philadelphia. so i moved to atlanta, georgia in 2001, and spent six years there are and it was quite a culture shock as you can imagine. i had to get used to seeing the occasionol con fred rat flags on the lawn, the jokes about the war of northern aggression, and just the idea that the civil war seeped into daily life and conversation down south in a way it never does up north. and the point was driven home when i was stuck in traffic on route 400. if anyone has spend time in atlanta you have been stuck in traffic on route 400 -- for two hours behind a pickup truck with a bumper sticker that said "don't blame me. i voted for jefferson davis." [laughter]
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>> who of course is the president of the confess was si. i was stuck behind the truck for two hours and had quite a bit of time to start thinking more in depth about the civil war, and my mind always goes, to what were the wimp doing? and not just any women. what were the bad women doing? the defiant women, in the revolutionary became doing? some women did things like knit socks and sew uniforms and hold bizarres to raise money for supplies. other women became informal recruiting officers especially southern women. they shamed any man who shirked his duty to fight. there was a great story about one southern lady who was very embarrassed by the fact her fiancee did not enlist so she sent over her slave with a backage and the package contained a skirt and a note and the note said ware this skirt or volunteer. he volunteered. and some women dared to go further. and i wanted to find four such
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women, women who lied, spied, dranked, and murdered their way through the war, and i think i managed to do that. my goal with the book was to weave a tapestry and tell the story of the civil war, hopefully in a way that had not been told before and it was important to me that their stories intersected in interesting ways. there was a cause and effect. one woman's circumstances would affect another woman's behavior and vice versa. throughout the war. i usually do this talk with a slide show and all of the slide is use are actually in the book. the book is foul pictures of the women and some civil war events and locales. this is the first time i'm doing it like this and i'm just going to tell you 12 of my favorite people, facts and events of the civil war. i'm going to start off with bell boyd; a 17-year-old girl living in virginia, when the war broker out.
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she was a confederate girl and was interesting to me because she was all -- she had no filter not even for herself. one of my favorite anecdotes of bell body has to do with a letter she sent to her cousin when she was 16, lobbying him to find her a husband. i'll read this letter. i am tall i weigh 106 and a half pounds. my form is beautiful. my eyes are of a dark blue and so expressive. my hair of a rich brown and i think i tie it up nicely. my neck and arms are beautiful. and my foot is perfect. only wear size two and a half shoes. my teeth the same pearly whiteness, i think perhaps a little whiter. nose quite as large as ever, beautifully shaped and indeed i am decidedly the most beautiful of all of your cousins. sobell had no problems with
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self-esteem. if you have to have a copy of the book you can look it up and make your conclusions about her beauty or lack thereof. she kicks things off in july of 1861. the union small group of union forces are marching up the -- they were planning on having a fourth of july celebration. publish... block...
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>> she decides to tap into her wide network of confederate family members and friends who are in the army and to get herself a piece of the army, to the contribute her own work for the rebels. and she becomes a courier and spy for the rebel army. and belle is a little bit of a seductress. it was very rare, especially in a 17-year-old girl. i like to say if sarah palin and miley cyrus had a 19th century baby -- [laughter] it would have been belle boyd. [laughter] she was a little bit like civil war girls gone wild. [laughter] and she seduced union men, confederate men. i like to file this one under things you can't make up. this is why i like nonfiction, it's always funnier than fiction. one of her reported paramours was a man by the name of major dick long. [laughter]
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i must be a 12-year-old boy, i found that really hilarious. [laughter] she also reportedly she told one northern reporter she was quote, closeted for four hours with union general james shields and subsequently wrapped a rebel flag around his head to celebrate this conquest. so men loved belle boyd. women did not like belle boyd quite as much. they had several nicknames for her, one of which was quote, the fastest girl in virginia or anywhere else more that matter. [laughter] but belle would go on to have many exciting adventures throughout the civil war that i talk about in the book. the next person that i want to talk about is a spy named private frank thompson. and private frank thompson comes into the war with a secret. private frank thompson is actually a woman named emma edmunds and has been living as a man for two years. and emma edmunds had quite an interesting and difficult childhood. she was born and raised in canada to a father who was
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increasingly disappointed by the fact that his of wife kept bearing sons -- excuse me, daughters. he wanted a son. and edmunds did her best to become a son figure to her father but still failed him. and he told emma he was going to arrange a marriage for her just as he had done for all of her older sisters, and emma didn't want any part of this. she craved the life of excitement for herself and she decided that one day she was going to cut her hair, bind her breasts and trade in her man suit for a woman's dress and start living, um life as private frank thompson. and she becomes an itinerant bible salesman and migrates to the united states and starts hearing about abolitionist john brown and decides she wants to enlist. she considers herself a devout christian and is against the idea of slavery and wants to fight for the union cause. so in the spring of 1861 in detroit, she enlists. and you might ask well, how
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could she pass the medical examination and fool the doctors in order to become a private for the union army? it's a good question, and, you know doctors across the country were told to conduct thorough medical examinations, but they all flouted these rules. they had quotas to fill, bodies to get out there as quickly as possible, so they conducted these rather cursory medical exams. they really only helped if you had powder cartridges, if you had enough fingers to pull the trigger and feet to march. that was pretty much it. so the doctor passes emma into the army, and she takes on the name private frank thompson, and she starts living among her comrades. and you might ask, well, how did they not detect she was a woman? after all, they're sleeping in the same tents etc., and how did they not, you know, discern that a woman was among them? and i came to the conclusion, i should say that emma was one of about 400 women for both north and south who disguised themselves as men and fought in
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the union or confederate armies. and i came to the conclusion that most of them got away with this because nobody knew what a woman would look like wearing pants. you know people were so used to seeing women's bodies pushed and pulled into these exaggerated shapes with corsets and cent lins that the very idea of a woman wearing pants was so unfathomable that even if she were standing in front of you wearing pants you wouldn't see it. so women sort of brilliantly exploited ideas of femininity and what a woman could look like in order to get away with this subterfuge. emma had to be careful. she was involved in of the war's bloodiest battles, but she had to be careful about being detected. if her gender were discovered, she could be arrested, charged
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>> these are confederate spies living in washington, d.c. and rose was in a very difficult position. her whole life had fallen apart in the years leading up to the war. she had lost five children in four year, if you can imagine
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that. she had lost her husband in a freak accident, and she had lost her access to the white house. this is somebody who had been friends with high ranking democratic politicians for years leading up to the civil war. she'd even been a close adviser to president james buchanan, and she lost all of this when lincoln and the republicans came into power and lincoln took over the white house. so in the spring of 1861 when a confederate captain approached rose and asked her to form a confederate spy ring in the capital of washington d.c., rose jumps at the chance and she begins cultivating sources -- by cultivating i mean sleeping with -- [laughter] also several union men. in fact, her most important source and reported lover was senator henry wilson of massachusetts who was not only an abolitionist republican, but he was also lincoln's chairman of the committee on military affairs. and here's a little brief clip of a love letter he purportedly wrote to rose.
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you know that i do love you. i am suffering this morning. in fact i am sick physically and mentally and know nothing that would soothe me so much as an hour with you. so you can imagine they had some very interesting and lucrative pillow talk that rose took full advantage of. my next favorite thing is rose greene's house cipher which is fascinating to look at. if anybody's familiar with edgar allen poe's story the bold bug it has mysterious-looking symbols that are concealing letters, numbers and words. rose had a very special symbol for president lincoln. it was this sort of upside down triangle bisected by a slash, and lincoln shows up in a lot of her cipher work. rose had two nicknames for president lincoln. weapon was bean pole, and the other -- one was bean pole and the other was satan. [laughter] gives you an idea of her feelings there. and it was really fascinating to learn more about her spy craft. when she didn't have time to
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write messages in her cipher, she found other ways to communicate with confederate officials. she learned the morse code, for example, and at certain appointed times confederate scouts were told to watch her windows for signals and rose would raise and lower her blinds according to to the dots and dashes of the morse code. and she could achieve the same effect by using the precise flutteringings of her fan -- flutterings of her fan, so pretty crafty there. and her spy craft proved useful very early on in the war. lincoln and the north basically thought the war was going to be over in 90 days. their grand plan was to meet the confederates at the battle of bull run. i once got in trouble for saying bull run in the south, so i won't make that mistake again, the battle of ma nas us, and they would advance on to richmond and win the war. well rose and the confederates had a different idea about this and in the days leading up to
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the battle, rose -- after seducing senator henry wilson and getting some valuable information -- summoned a 16-year-old courier named betty to her home on lafayette square in washington, d.c., and she wrote up a dispatch and tied it up in a piece of black silk and rolled it up in betty's hair so it was cleverly concealed much like my hair's probably carrying a few dispatches right now. [laughter] and she told betty duval that she was just going to cross over the lines, and the union sentries would think she was nothing more than a pretty girl on her way home from market. they'd wave her on through. so betty goes across the lines and she arrives at general beauregard's headquarters, undoes her hair in a dramatic and romantic fashion and hands over this note which basically told the confederate forces exactly how many union troops to expect and when they were planning on marching so the confederates could position
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themselves and be ready. and we of course, we we know the confederates kicked some butt and the war would go on much longer than 09 days, obviously. next -- t 0 cays. next american is a union spy by the name of elizabeth van lieu. she was number one a union spy living in the confederate capital of richmond, so they were opposed on that front. and whereas rose was outspoken and brazen, elizabeth was quiet and discreet and really cunning. and whereas rose was a celebrated beauty one of elizabeth's contemporaries wrote that she was, quote: never as pretty as her portrait showed. [laughter] yeah. if you could see the picture of elizabeth, it's quite cruel. but elizabeth also had an interesting upbringing. she was born and raised in richmond but was sent north to philadelphia to be educated and was under the care of an
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abolitionist governess. when she returned to richmond, she was appalled at the condition of the slaves, and she had become an abolitionist herself and decided to fight for the union cause. before the war people thought elizabeth was just sort of eccentric. she was a strange woman who had never married, she was living with her mother in this grand old mansion in richmond, she was sort of an eccentric character. but after the war it was very dangerous for elizabeth to be outspoken about abolitionist opinions and to have of a perceived northern sympathy. she was the recipient of many death threats from her neighbors, confederate detectives followed her wherever she went. but nevertheless, elizabeth decided to form a union spy ring in the confederate capital of richmond, and she began recruiting people from all walks of life. one of them was her brother by the name of john van lew and i had the great pleasure of calculating with the great grand -- of connecting with the great grandson of one of john's
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towers, and he told me -- daughters, and he told me incredible things. and just to give you a little taste of that, it mostly had to do with family's hardware businessment they had a prominent hardware business for years in richmond and one of the most impressive buildings in the state of virginia. and he used the hardware business as a front for his spy ring in a way. he would take blank invoices and purchase orders and fill them out as if they were regular business documents but every number he wrote down corresponded with certain military terminology. for example 370 iron hinges might mean 3700 cavalry. so when he crossed the lines and confederates looked at his papers, they would just think this was the normal course of business, but once he got over to union lines and to his contacts, he was able to interpret everything and give them the information they needed. but elizabeth van lew's great coup was in the form of a woman
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named mary jane becauser. elizabeth had freed all of the family slaves, and many of them had stayed on to work for her, and elizabeth got a bright idea. she had heard that verena davis who was jefferson davis' wife, needed to staff the white house. she was looking for help and she put out a call to the social rideties of richmond to -- ladies of richmond to help her staff the white house and send over any good recommendations for staff. and elizabeth decided to pay mrs. davis a business. and she says well, i have a girl for you. she's not very bright and she stumbles in the kitchen, but she's loyal, and she'll work very hard for you and your family. so elizabeth sends over mary jane bowser who was a former family slave in the van lew household. and little does anyone know that mary jane is not only literate but gifted with a photographic memory. so while she's dusting jefferson davis' desk and picking up the children's toys she's also
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sneaking peeks at his confidential papers and eavesdropping on his conversations and reporting all of this back to elizabeth van lew. what made all of this even more dangerous and adding another layer of treachery was that john van lew, elizabeth's brother was married to an ardent confederate sympathizer, and they're all living in the same house. so they're conducting all of this business knowing that there's somebody amongst them who, if she had any inkling about what they were doing or any evidence, she would not hesitate to report this immediately to confederate authorities. and elizabeth knew that as well. the next person i'd like talk about is confederate general stonewall jackson who i'm sure, is a very familiar person to many people in this room. and i like stonewall. he was sort of the rock star of the civil war. he was sort of my civil war boyfriend. i liked him such an eccentric interesting, brilliant man. but i like the way that southerners perceived him in particular and the way they
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treated him. and it was a great story i came across about stonewall jackson in a hotel lobby in the shenandoah valley in 1862. and women are cornering him, they're swarming him, they're ripping buttons off of his coat and keeping them as souvenirs and belle boyd is among this crowd. she reports that she hears him say, ladies, ladies, this is the very first time i've been surrounded by the enemy. laugh -- [laughter] smooth guy right? so belle boyd, of course is obsessed with stonewall jackson. so obsessed that she tells reporters that she wants to quote: occupy his tent and share his dangers. [laughter] which if i were stonewall jack soften, would have frightened me more than anything the -- jackson would have frightened me, just the fact that belle boyd wanted to sleep this my tent. would have been enough to make me run. my next one is blockade runners of the civil war, and i usually show a cartoon with this depicting a woman's cent lin
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that at the apex of its popularity reached a diameter of six feet. >> southern women were quite expert at this she managed to conceal a roll of army cloth, several pairs of cavalry boots a roll of crimson flannel cans of preserved meats and a bag of
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coffee. that was the contraband tally for a single crossing. [laughter] belle boyd was sort of the queen of this blockade and she specialized in smuggling weaponnings. and she sort of recruited a group of southern ladies to help her in this endeavor. and one fall morning in 1861 the 28th pennsylvania aa woke to -- awoke to discover 400 pistols cavalry equipment for 200 men and 1400 musket were missing. waiting transfer to southern lines thanks to belle boyd and her network of ladies. and to me, this was one of the most fascinating parts about women's roles in the civil war. they were able to to take society's ideas and constructs about womanhood and perceived weaknesses and exploit them brilliantly to their own benefit. and they used their gender as a psychological disguise. physically, they're hiding things in their hair, under their hoop skirts and psychologically women would have
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a ready answer if they were ever accused of treasonous activity. and this had happened a couple of times to elizabeth van lew and her response always was how dare you accuse me of such behavior. i am a defenseless woman, you know? [laughter] and it worked. it was something that people did not know how to respond to and it was that and it was quite an effective and brilliant way -- [inaudible] the next person is detective allen pinkerton and i had no idea he was this involved in secret service work during the war, but he was. he was hired to do secret service work for the union army, and his first mission was to conduct a stakeout on confederate spy rose greenhelm. allen pinkerton and two of his best men go to rose's home on lafayette square. rose always liked to say, by the way, her home was quote, within rifle range of the white house.
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[laughter] and allen pinkerton has to get up stand on two of his detectives' shoulders just to peek in her window, and what does he see, but rose sitting there on the couch with a traitorous union captain, and they're looking over maps and fortifications and papers that clearly have information about the war and about union plans. and pinkerton is furious. pinkerton declares rose public enemy number one and decides he's going to make it his mission in life to get rose which makes for some interesting cat and mouse activity as the war goes on. and this was also another entering part about women's roles in the civil war -- interesting part about women's roles in the civil war. women had always been victims of war, they were never perpetrators, and loyalty was the prime attribute of femininity itself. women's loyalty was always assumed. so for the very first time they're grappling with the idea that women are not only capable
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of treasonous activity but they're more capable than men. one lincoln official had this great quote that sort of sums it up he says: what are we going to do with these fashionable women spies? and it's something they have to spend quite a bit of time answering. my next person is a fellow by the name of benjamin stringfellow. he is a confederate spy for general jeb stewart. he had blond hair blue eyes, and he weighed 94 pounds. one of his come raids said he had a waist -- comrades said he had a waste just like a woman's. he had sort of an ingenious mode of getting his information. he would dress in elaborate ball gowns and go to union military balls and wait for the men to ask him to dance. and they did ask him to dance. they thought sally martin was very charming.
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and while sally martin was dancing with these union soldiers, she would find out whatever she could about ulysses s. grant's plans and report it back to general jeb stewart. because -- so i like to include him because it just goes to show the men were in on the cross-dressing action during the civil war too. [laughter] number 11 is spy disguises. i was fascinated by the way people disguised themselves as spies during the civil war. things that seem so rudimentary and primitive today. people would have epileptic fits, one guy removed his glass eye, they would feign a limp, they would pose as peddlers itinerant photographers and some people disguised themselves as slaves which i thought was odd until it makes sense when you think about just as nobody expected a woman to disguise themself as a man, nobody expected people to disguise
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themselves as slaves. it was all well and good unless it became excessively hot or started raining and your disguise literally started running could down your skin. this actually happened to one of my spies later on in the book. and number 12 my favorite things during the civil war, was how the female soldiers got caught. i mentioned earlier there were about 400 women who disguised themselves a men and en-- as men and enlisted in the war and you know, the reports started circulating as the war went on about women, you know, in the reactions. and people were -- in the ranks and people were shocked about this. even more shocking to me was how they were discovered. there was one private her captain threw an apple at her, and she tried to grab the hem of her nonexistent apron to catch the apple, thereby giving herself away since she was not warring an apron. one woman recruit reportedly forgot how to put on pants.
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she tried to pull them over her head. [laughter] and the final one and my very favorite, a corporal in new jersey gave birth while she was on picket duty. [laughter] so the jig was up. so anyway those are my 12 favorite people, events and facts of the civil war. if anybody has any questions or any stories or wants to tell me how their own ancestors got rid of the damn yankees, i would love to hear it. [applause] >> [inaudible] line up here. in. >> [inaudible] rose -- came back from europe, whatever happened to little rose
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who she left in a convent in paris? >> um, the question was about rose and what happens to her after the war. and just to back up a little bit about that later on in the war rose was sent by jefferson davis to be a lobbyist on behalf of the confederacy to try to convince england and france to recognize the south as its own legitimate country which was unprecedented for an american president of the south, you know the south obviously considered itself its own country, to send a woman to do its business. so that was quite a remarkable thing. and what happens to rose's daughter after the war? she grows up and gets married and misses her mama very dearly and there's not too much information about, about little rose. but she does marry and sort of go on to have her own happy and productive life. but she and her mother were very close, and i should say that little rose was an important
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mother -- part of her mother's spy plans. her mother would often use her daughter to send messages and hide messages and things like that. so rose o'neill greenhowe was is so invested in the southern cause she was willing to not only risk her own life, but that of her 8-year-old daughter as well. >> any more questions? [inaudible conversations] >> well, thank you all. thanks for coming. [applause] >> a great story and a very true story. if you'd like to get your book signed, please allow her to leaf the sanctuary so she can go to
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telfair square and we hope to see you back here at 4:10 when donald miller will talk about the jazz age. thank you. [inaudible conversations] [inaudible conversations]
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[inaudible conversations] >> and that was author karen abbott talking about her book, "liar, temptress soldier, spy: the story of four women who served undercover during the civil war." we've got one more panel to show you, and this is about prohibition era manhattan. that will begin in about 20
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minutes. [inaudible conversations] [inaudible conversations] there are. [inaudible conversations]

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